Individual provider Active NPI

Jayshree N Rathod, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1457943144
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5014205 Issued in NC
Practice address
10515 Mallard Creek Rd
Charlotte, NC 28262-9785
Phone
(704) 547-9739
NPI assigned
Feb 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 5014205 NC Primary
Family Nurse Practitioner 363LF0000X F12200611 NC

Addresses

Primary practice location

10515 Mallard Creek Rd
Charlotte, NC 28262-9785

Mailing address

10515 Mallard Creek Rd
Charlotte, NC 28262-9785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211201000480 NC Practitioner - Nurse Practitioner 7810387149 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians

Practice addresses (Care Compare)

13304 Leesville Church Rd
Raleigh, NC 27617-5206
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F12200611NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care North Carolina PLLC Family CurrentSince Jun 4, 2025 Accepting new patients
Minuteclinic Diagnostic of North Carolina PC Family CurrentSince Oct 6, 2021 Accepting new patients

Locations

10100 S Main St
Archdale, NC 27263
Phone (336) 431-0715

10515 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 494-3466

13304 Leesville Church Rd
Raleigh, NC 27617
Phone (919) 845-2489

2340 Spring Forest Rd
Raleigh, NC 27615
Phone (919) 790-6401

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: jrathod36876@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1457943144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10515 MALLARD CREEK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10515 MALLARD CREEK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629785",
            "telephone_number": "704-547-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHOD",
        "first_name": "JAYSHREE",
        "middle_name": "N",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-04",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014205",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F12200611",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.